Category: Marriage & Family Therapy, Social Work
Drug Addiction Counseling NBCC, NASW approved.
Course Description
Acknowledgment
The material for this course is based on clinical studies and reports published by
National Institute on Drug Abuse
National Institutes of Health
6001 Executive Blvd., Room 5213
Bethesda, MD 20892-9561
U.S.A.
Evaluation of Individual Objectives
To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.
Learning Objectives
Upon completing the course, you will able to:
- Describe the beliefs and philosophy of 12-step approach to recovery.
- Distinguish between addiction counseling and psychotherapy.
- Discuss the logistics of the individual drug counseling model to treat cocaine addiction, such as frequency, duration, target population and setting of sessions.
- Describe the application of Addiction Severity Index in the assessment of drug addiction.
- Describe the patient-counselor relationship and list behaviors that the counselor should not indulge in.
- List behaviors that a counselor should not indulge in.
- List 12 objectives of individual drug counseling.
- Describe 4 stages of addiction treatment: Treatment initiation, Early abstinence, Maintenance of abstinence, Advanced recovery.
- List some of the erroneous beliefs that a patient experiencing denial may exhibit.
- Outline 3 goals of the treatment plan and make detailed plans for introductory sessions.
- List 5 goals of the second stage in the treatment of addiction, i.e., abstinence, and discuss 10 treatment issues with the patient.
- Establish goals for maintaining abstinence and discuss various treatment issues with the patient as part of the ongoing recovery program.
- Identify 11 steps that will carry a patient toward relapse.
- Define codependency and enabling behavior and explain how they can contribute to a person’s continued abuse of drugs.
- Identify “character defects” that are obstacles to further recovery and outline the process for working on changing defects.
- Discuss with the patient patient’s thoughts and feelings about ending treatment in the final active treatment session.
- Explain the purpose and goals of treatment booster sessions.
- Identify 3 levels of severity of relapse and list appropriate interventions to be used in each case.
- Discuss strategies for dealing with crises and relapses.
- List ideal personal characteristics of an addiction counselor.
- Explain the purpose and application of adherence scale in the IDC model.
- Identify 6 important features of cognitive-behavioral therapy that make it particularly promising as a treatment for cocaine abuse and dependence.
- Distinguish between cognitive-behavioral therapy (CBT) and 12-step or disease-model approach.
- Compare CBT to other psychosocial treatments for substance abuse, such as cognitive therapy, community reinforcement approach, motivational enhancement therapy, 12-step facilitation and interpersonal psychotherapy.
- Discuss two critical components of CBT: functional analysis and skills training.
- Define various parameters of CBT such as format, length, setting, patients and compatibility with other adjunctive treatments.
- List essential and unique interventions of CBT, interventions that are recommended but not unique, acceptable interventions and interventions that are not part of CBT.
- Describe 7 strategies a counselor would use to help the patient master new skills.
- Enunciate the basic principles of cognitive-behavioral therapy and describe how functional analysis and skills training are used to treat cocaine addiction.
- Describe the CBT principle that holds forth the three ways individuals learn to use drugs: modeling, operant conditioning, and classical conditioning.
- Describe the structure and format of a typical CBT session using the “20/20/20 Rule” and list tasks to be completed during each part of the session.
- List 8 skill topics covered in CBT for cocaine dependence.
- Outline the pharmacotherapy approach as used in cognitive-behavioral therapy.
- Explain the treatment goal of cognitive-behavioral therapy.
- List six strategies a counselor can use during a treatment session to enhance motivation and avoid resistance.
- Outline the CBT model providing an explanation and rationale for the treatment.
- Help the patient understand craving.
- Elicit from the patient the experience of craving.
- List 5 strategies to cope with cravings.
- Provide key interventions to shore up motivation and commitment to stop.
- List three basic principles in effective refusal of cocaine and other substances.
- Identify examples of Seemingly Irrelevant Decisions and their relationship to high-risk situations.
- Help the patient identify high-risk situations and develop a coping plan.
- Help the patient practice problemsolving skills within the session by listing 5 basic steps.
- Develop a concrete support plan for addressing psychosocial problems that present a barrier to treatment.
- Assess the patient’s risk for HIV infection and build motivation to change risk behaviors.
- Set behavior change goals.
- Formulate specific HIV risk-reduction guidelines
- Involve significant others so that they can help patients become and remain abstinent.
- Identify 6 strategies in which the significant other can offer support to the patient in his or her recovery.
- Explore strategies through which significant others in the patient’s life can help the patient become and remain abstinent.
- List guidelines for effective supervision.
- Identify some of the common problems encountered in supervision.
- Review clinical research supporting CBT and compare its effectiveness against Interpersonal Therapy and Clinical Management.
- Relate the efficacy of CRA+Vouchers approach over standard drug counseling and cite research studies to support this conclusion.
- Adopt a counseling style and techniques consistent with the CRA+Vouchers treatment program.
- List 3 categories of patients generally acceptable for the CRA+Vouchers program.
- Outline the intake process listing various self-administered questionnaires.
- Conduct the initial treatment session taking the patient through several steps.
- List the tasks a therapist should complete in Sessions One and Two of the program.
- Explain the concepts and procedures concerning functional analysis as the first step of CRA+Vouchers treatment plan.
- Instruct the patient on the four components of the functional analysis.
- Help the patient develop self-management plans for handling triggers to reduce the risk of cocaine use.
- Instruct the patient in five components of effective refusal.
- List at least 6 lifestyle change components for cocaine abusers in treatment.
- Explain the importance of time management in achieving and maintaining abstinence from cocaine, and help the patient develop time-management skills.
- Provide a rationale for working on lifestyle changes in social and recreational areas.
- List 5 basic steps for problem-solving.
- Help patients develop assertiveness skills, and distinguish between passive, aggressive and assertive behaviors.
- Describe the purpose of relationship counseling and take the patient through various steps to improve the quality of his or her relationship.
- Outline the general strategy for dealing with concurrent alcohol and cocaine use.
- Introduce disulfiram protocol and develop compliance procedures.
- Outline the general strategy for dealing with marijuana use concurrent with cocaine.
- Describe the treatment protocol for dealing with depressive symptomatology and anxiety
- following abstinence from cocaine.
- Describe the function of clinical supervision of therapists in the CRA+Vouchers program.
- Describe the behavioral treatment in drug abuse treatment as contingency management.
Table of Contents
- Introduction
- Treatment Philosophy
- Contributions of the 12-Step Approach
- Role of Self-Help Groups
- Role of Significant Others in Treatment
- Comparison of Addiction Counseling and Psychotherapy
- Similar and Dissimilar Approaches
- Compatibility With Other Treatments
- Frequency and Duration of Sessions
- Duration of Treatment
- Target Population
- Setting
- Assessment
- Addiction Severity Index
- Biological Assays
- Patient-Counselor Relationship
- Therapeutic Alliance
- Behaviors That Should Not Be Done
- Goals and Objectives of Individual Drug Counseling
- Stages of Treatment
- In Each Session
- Goals
- Treatment Issues
- Denial
- Introductory Sessions
- Treatment Issues
- Goals
- Treatment Issues
Customer Comments
“Excellent course! Highly recommended!” – O.I., RN, CA
“I enjoyed this class!” – B.B., LPC, SC
References
- Psychosocial Interventions
- Supporting Research
- Use With Other Populations
- Concurrent Alcohol Dependence
- Lifestyle Changes
- Vouchers
- Other Drug Abuse
- Treatment Parameters Schedule
- Schedule
- Components
- Structure
- Exhibit 1: Sample Schedule
- Counseling Style
- Flexibility
- Empathy
- Active Involvement
- Directive But Collaborative
- Social Reinforcement
- Counseling Techniques
- Behavioral Techniques
- Additional Resources
- Progress Graphs
- Counseling Structure
- Preparation
- Session Protocol
- Recent Problems or Crises
- Special Issues
- Absences
- Tardiness
- Extra Sessions
- Drug and Alcohol Use
- Concurrent Treatment
- Premature Termination
- Documentation of Patient Contact
- Clinical Supervision
- Exhibit 2: Therapy Session Checklist
- Exhibit 3: Progress Note
- Exhibit 4: Brief Contact Forms
- Objective Monitoring
- Exhibit 5: Recommended Reinforcement Schedule
- Urinalysis Schedule
- Specimen Collection
- Laboratory Analysis
- Presenting the Results
- Initial Contact
- Screen Applicants
- Schedule Intake
- Intake Procedures
- Assessment
- Self-Administered Questionnaires
- Program Description
- Structured Interviews
- Initial Treatment Session
- Get to Know the Patient
- Provide Overview and Rationale
- Introduce the Voucher Program
- Describe Abstinence Contract
- Explain Urinalysis Monitoring
- Explain Voucher Program
- Review Abstinence Contract
- Priming
- Problem List
- Practical Needs Assessment
- Appointment Book
- Significant Others
- Disulfiram Procedures (if applicable)
- Collect Urine
- Schedule the Next Session
- Exhibit 7: Intake Worker Summary
- Exhibit 9: Sample Abstinence Contract
- Exhibit 10: Problem List Form
- Exhibit 11: Sample Problem List
- Outline a Treatment Plan
- Sessions One and Two
- Urinalysis Results
- Complete Intake and Treatment Orientation
- Introduce Functional Analysis and Stimulus Control
- Assist With Practical Needs
- Use the Appointment Book
- Start To Develop the Treatment Plan
- Discuss Areas for Change
- Prioritize Problems
- Set Specific Target Goals
- Follow Through
- Functional Analysis
- Components of Functional Analysis
- Triggers
- Behavior
- Positive Consequences
- Negative Consequences
- Conduct a Functional Analysis
- Self-Management Planning
- Rationale
- Initiate Training
- Make the Plan
- Drug Refusal Training
- Rationale
- Refusing Cocaine and Other Drugs
- Components of Effective Refusal
- Practice Refusal Skills
- Homework
- Exhibit 13: Discovering Triggers of Your Cocaine Use
- Exhibit 14: Functional Analysis – Cocaine Behavior Form
- Exhibit 15: Functional Analysis – Cocaine Behavior Form (example)
- Exhibit 16: Components of Effective Refusal
- Time Management
- Develop Time-Management Skills
- Apply Time Management
- Social/Recreational Counseling
- Rationale
- List Activities and People
- Set Goals and Assess Progress
- Facilitate Change
- Problem-solving
- Rationale
- Steps for Problem-solving
- Recognize the Problem
- Identify the Problem
- Brainstorm
- Select Approach
- Evaluate Effectiveness
- Practice
- Vocational Counseling
- Rationale
- Set Goals
- Treatment Components
- Social-Skills Training
- Assertiveness Training
- Rationale
- Assertiveness Skills
- Practice
- Set Goals and Assess Progress
- HIV/AIDS Prevention
- Rationale
- AIDS Knowledge Pretest
- Video and Discussion
- Pamphlets and Condoms
- AIDS Knowledge Posttest
- HIV Antibody and Hepatitis B Testing
- Provide Information
- Discuss Results
- Exhibit 17: Problem-solving Worksheet
- Procedure
- Practice Exercise
- Exhibit 18: Being Assertive
- Exhibit 19: AIDS Risk Knowledge Test
- Exhibit 19a: AIDS Risk Knowledge Test (Answers)
- Exhibit 20: Recommendations to Prevent HIV Transmission Through Shared Drug Injection Equipment
- Session 1
- Introduce Relationship Counseling
- Introduction Exercise
- Relationship Happiness Scale
- Daily Reminder To Be Nice
- Session 2
- Perfect Relationship Form
- Positive Requests
- Session 3
- Communications Training
- Session 4
- Communications Training
- Sessions 5-8
- Exhibit 21: Relationship Happiness Scale
- Exhibit 22: Examples of Relationship-Related Activities
- Exhibit 23: Daily Reminder to be Nice
- Exhibit 24: Perfect Relationship Form
- Exhibit 25: Positive Requests
- Exhibit 26: Reciprocal Contract for Behavior Change
- Disagreements
- Conflicts
- General Approach
- Treatment Goals
- Abstinence
- Reduced Use
- No Intervention
- Concurrent Alcohol Use
- Abstinence
- What Is Disulfiram?
- Medical Oversight
- Disulfiram Protocol
- Exhibit 29: Disulfiram Consent Form
- Exhibit 30: Disulfiram Contract
- Exhibit 31: Therapist’s Disulfiram Checklist
- Exhibit 32: Backup Disulfiram Contract
- Introduce Disulfiram
- Limited Alcohol Use/Safe Drinking
- Patients Who Hesitate or Refuse
- Backup Agreement
- Marijuana Use
- Depressive Symptomatology
- Evaluate Suicide Risk
- Monitor Symptoms
- Treatment
- Anxiety
- Relaxation Protocol
- Relaxation Exercise and Practice
- Applications
- Insomnia Protocol
- Rationale
- Sleep Diary
- Sleep-Hygiene Rules
- Sleep Restriction and Stimulus Control
- Practice
- Exhibit 34: Sleep Hygiene Rules
- Exhibit 35: Sleep-Restriction and Stimulus-Control Instructions
- Weekly Clinical Staff Supervision
- New Cases
- Active Cases
- Counselor Treatment Team Meetings
- Exhibit 36: Supervisor Checklist by Case